Some women in our community choose bilateral orchiectomy prior to or instead
of vaginoplasty. This medical
procedure is also called orchidectomy or gonadectomy and is commonly known as
castration or by the abbreviations "orch," "orchi," "orchy,"
and "orchie." Bilateral orchiectomy involves removal of both testicles,
which eliminates the sources of androgen production.

This procedure is most often performed by urologists or endocrinologists and
is sometimes done for treatment of prostate
cancer and testicular
cancer in non-trans patients.

Because it is considerably less expensive than vaginoplasty, orchiectomy may
be a good intermediate step for those with limited finances. It eliminates the
need for antiandrogens and allows patients to take lower doses of feminizing
hormones. However, it can affect the amount of tissue available for vaginoplasty
over time and leaves small scars which may affect a later vaginoplasty result.

Orchidectomy is less drastic than vaginoplasty, but it has historically been
difficult for transwomen to obtain it.

Because an orchiectomy is irreversible, you must make sure you understand your
reproductive options before undergoing
this procedure.

If you intend to get vaginoplasty at a later date, you should speak with the
surgeon(s) you are considering before getting an orchiectomy. Some of them may
have suggestions or recommendations about incision placement to ensure a better
vaginoplasty result at a later date.

Some women have been able to change legal
documents following orchiectomy. You will need to ask your surgeon for a
letter affirming that the surgeon performed irreversible genital surgery as
part of a sex change procedure.

Unqualified people performing the procedure

When our community was still frequently denied access to medical services last
century, some consumers sought out this procedure from people without adequate medical
training or equipment. Some attempted to perform the procedure on themselves,
which frequently led to hospitalization. This is very dangerous and can lead to death or serious injury. I strongly urge you to seek out a qualified practitioner to perform this procedure
under the safest conditions.

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